International Urogynecology Journal

, Volume 23, Issue 11, pp 1569–1576

Magnetic resonance imaging of abdominal versus vaginal prolapse surgery with mesh

  • Shimon Ginath
  • Alan D. Garely
  • Jonathan S. Luchs
  • Azin Shahryarinejad
  • Cedric K. Olivera
  • Sue Zhou
  • Charles J. Ascher-Walsh
  • Alexander Condrea
  • Michael L. Brodman
  • Michael D. Vardy
Original Article

DOI: 10.1007/s00192-012-1783-2

Cite this article as:
Ginath, S., Garely, A.D., Luchs, J.S. et al. Int Urogynecol J (2012) 23: 1569. doi:10.1007/s00192-012-1783-2

Abstract

Introduction and hypothesis

We compared two surgical approaches in patients with symptomatic prolapse of the vaginal apex with normal controls by analyzing pelvic landmark relationships measured using magnetic resonance imaging (MRI) before and after surgery.

Methods

In this prospective multicenter pilot study involving 16 participants, nulliparous controls (n = 6) were compared with ten parous (3.0 ± 1.0) women with uterine apical prolapse equal to or greater than stage 2. Group A (n = 5) underwent abdominal sacral colpopexy with monofilament polypropylene mesh and group B (n = 5) with vaginal mesh kit repair (Total ProLift). Subtotal hysterectomy was performed in all group A and no group B women. All patients underwent preoperative and 3-month postoperative Pelvic Organ Prolapse Quantification (POP-Q) and dynamic MRI. Comparison of MRI pelvic angles and distances was performed and analyzed by Mann–Whitney rank sum test and chi-square test.

Results

Vaginal apical support is similar at 3 months for abdominal sacral colpopexy (ASCP) and ProLift by POP-Q examination and MRI analysis. In both treatment groups, the postoperative POP-Q point C and MRI parameters were similar to nulliparous controls at 3 months.

Conclusions

Anatomic outcomes for ASCP compared with ProLift were similar at 3 months in terms of vaginal apical support by POP-Q and MRI analysis. Continued comparative analysis of postoperative support with objective imaging seems warranted.

Keywords

Abdominal sacral colpopexy Monofilament polypropylene mesh ProLift Pelvic organ prolapse Magnetic resonance imaging 

Abbreviations

POP

Pelvic organ prolapse

ASCP

Abdominal sacral colpopexy

VSCP

Vaginal sacrospinous colpopexy

MRI

Magnetic resonance imaging

MPM

Monofilament polypropylene mesh

POP-Q

Pelvic Organ Prolapse Quantification

Copyright information

© The International Urogynecological Association 2012

Authors and Affiliations

  • Shimon Ginath
    • 1
    • 2
    • 3
    • 4
    • 6
  • Alan D. Garely
    • 2
  • Jonathan S. Luchs
    • 5
  • Azin Shahryarinejad
    • 1
    • 2
    • 3
  • Cedric K. Olivera
    • 1
    • 2
    • 3
  • Sue Zhou
    • 1
    • 2
    • 3
  • Charles J. Ascher-Walsh
    • 1
  • Alexander Condrea
    • 4
  • Michael L. Brodman
    • 1
  • Michael D. Vardy
    • 1
    • 3
  1. 1.Department of Obstetrics, Gynecology and Reproductive ScienceMount Sinai School of MedicineNew YorkUSA
  2. 2.Department of Obstetrics and GynecologyWinthrop University HospitalMineolaUSA
  3. 3.Department of Obstetrics and GynecologyEnglewood Hospital and Medical CenterEnglewoodUSA
  4. 4.Department of Obstetrics and GynecologyWolfson Medical Center, Holon, and Sackler School of MedicineTel-AvivIsrael
  5. 5.Department of RadiologyWinthrop University HospitalMineolaUSA
  6. 6.Department of Gynecology and ObstetricsE. Wolfson Medical CenterHolonIsrael

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